Predictors of Empathy: Do Spirituality, Religion, and Calling Matter?

Caroline Thomas, Medical Student, University of Chicago Pritzker School of MedicineFarr Curlin, MD, University of Chicago John Yoon, MD, University of Chicago Hyo Jun Tak, University of Chicago and University of North Texas Health Science Center Objective: Empathy is a common theme amongst all major religious texts, and physicians who place a high importance on religion may be more likely to self-report high levels of empathic concern towards their patients. Importantly, empathic concern is associated with accuracy of prognosis and good clinical outcomes for patients including HbA1c and LDL control. Thus, the purpose of this study is to determine whether physician spirituality, religion, or a sense of calling towards medicine are predictors of self-reported empathy. Methods: We sampled 2000 practicing physicians from all specialties via the AMA master file and measured self reported empathy via the Davis IRI, Religiosity via the Hoge Intrinsic Religiosity short form, theological pluralism, and medicine as a calling and used OLS regression adjusted for factors that may affect self-reported empathy (work environment, primary care vs. lifestyle specialty, gender, and age). Results: Physicians who reported that religion was fairly important (coefficient = 0.766, p =0.047), very important (coef. = 1.474, p <0.001), or most important (coef. = 1.680, p < 0.001) had statistically higher empathy scores than their counterparts who self reported no religion (reference) or that religion was not important (coef. = 0.597, p=0.137). Physicians who rated themselves as moderately (coef. = 1.36, p < 0.001) or very spiritual (coef. = 2.091, p < 0.001) had higher reported empathy scores than their counterparts, who reported that they were not at all spiritual (reference) or slightly spiritual (coef. = 0.441, p = 0.268). Those who scored as having moderate (coef. = 0.283, p = 0.280) or high intrinsic religiosity (coef. = 0.733, p = 0.001) also had higher empathy scores compared to low intrinsic religiosity. Of note, moderate (coef. = 0.388, p = 0.144) and high (coef. = 0.618, p = 0.018) theological pluralism was associated with higher empathy levels as well compared to low theological pluralism. Conclusion: This study of a large, nationally representative sample of US physicians suggests that there is a positive relationship between empathy and religion, spirituality, intrinsic religiosity, and theological pluralism. Empathy has long been linked to prosocial behaviors such as altruism and generosity, and has been described as an essential component to delivering compassionate care to patients. This study raises the question of whether attention to and cultivation of religious motivations may help many US physicians develop and sustaining empathy.